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Topic: Etomidate

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	Intravenous anesthetic induction agents : etomidate ( Amidate ) (Site not responding. Last check: 2007-11-03)
		Etomidate's rapid distribution half life (t 1/2 alpha = 2.81 +/- 1.64 min), short elimination half life 1/2 beta = 3.88 +/- 1.11 hr) and rapid clearance (954 +/- 178 ml/min) explain its rapid onset and short duration of action.
		The compound produces electroencephalographic changes and effects on cerebral blood flow, metabolism and intracranial pressure that are similar to sodium thiopental, suggesting that it may have a place in neurosurgery and as a "brain protective" agent in patients at risk of a brain hypoxic insult.
		Etomidate did not affect hepatorenal and hematologic function after repeated injections in animal toxicology studies, but few investigations addressing its effects on hepatic, renal, and neuromuscular function in man have been accomplished.
	www.general-anaesthesia.com /etomidate.htm (256 words)

	CJEM \| JCMU 2002; 4(3) :: Pharmacotherapy (Site not responding. Last check: 2007-11-03)
		Etomidate is rapidly hydrolyzed by liver and plasma esterases to an inactive metabolite, etomidate carboxylic acid.
		Etomidate's 30% to 40% incidence of nausea and vomiting is higher than the 10% to 20% seen with thiopental.
		Etomidate has minimal respiratory effects relative to thiopental or propofol; however, in patients with asthma or reactive airway disease, ketamine remains the induction agent of choice because of its bronchodilating effects.
	www.caep.ca /004.cjem-jcmu/004-00.cjem/vol-4.2002/v43-194.htm (3344 words)

	Influence of Hypovolemia on the Pharmacokinetics and the Electroencephalographic Effect of Etomidate in the Rat -- De ...
		The aim of this study was to investigate the influence of hypovolemia on the pharmacokinetics and the EEG effect of etomidate.
		In the hypovolemic animals, the infusion of etomidate was accompanied by a decrease in MAP and HR.
		De Paepe P, Belpaire FM, Rosseel MT and Buylaert WA (1998) The influence of hemorrhagic shock on the pharmacokinetics and the analgesic effect of morphine in the rat.
	www.jpet.org /cgi/content/full/290/3/1048 (4195 words)

	Etomidate : Epilepsy.com/Professionals
		Etomidate is a hypnotic nonbarbiturate, ultra—short-acting anesthetic agent associated with involuntary muscle movements in 10—70% of patients.
		Etomidate is often administered because of its cardiovascular stabilizing effect.
		Despite the lack of evidence that etomidate causes seizures in nonepileptic patients, epileptiform activity occurred in 6 of 30 nonepileptic patients who were induced with etomidate for heart valve replacement.
	professionals.epilepsy.com /page/general_etomid.html (250 words)

	Etomidate
		Intravenous etomidate is also indicated for the supplementation of subpotent anesthetic agents, such as nitrous oxide in oxygen, during maintenance of anesthesia for short operative procedures such as dilation and curettage or cervical conization.
		When etomidate was used for both induction and maintenance of anesthesia in short procedures such as dilation and curettage, or when insufficient analgesia was provided, the incidence of postoperative nausea and/or vomiting was higher than that noted in control patients who received thiopental.
		The LD of etomidate administered intravenously to rats is 20.4 mg/kg.
	www.mindwheels.com /ED-WEB%20Web/Etomidate.htm (1985 words)

	Etomidate-containing compositions - Patent 4289783
		Etomidate, being chemically designated as R-(+) ethyl 1-(1-phenylethyl)-1H-imidazole-5-carboxylate is a short-acting hypnotic agent, belonging to the class of allyl 1-(1-phenylalkyl)-1H-imidazole-5-carboxylates which are described in U.S. Pat.
		Besides etomidate hydrochloride or hydrobromide the medium may obviously contain other solvents and/or substances which do not adversely affect the stability and the efficacy of the composition nor its ability to be diluted with physiological liquid.
		The concentration of etomidate in the composition for intravenous (i.v.) administration may vary within rather wide limits depending on the rate of infusion and the dose requied by the specific circumstances.
	freepatentsonline.com /4289783.html (1498 words)

	Etomidate and Adrenal Supression (Site not responding. Last check: 2007-11-03)
		Hi, I do not know the exact answer to etomidate and indications in trauma patients regarding the adrenal suppression, but in my opinion the perfect agent to intubate trauma patients is Ketamine.
		We were reading about Etomidate and his potential deleterious effects on septic shock patients, were the adrenal supression that happens after one single bolus dose may be significant enough to increase mortality.
		Etomidate is the first choice agent to intubate trauma patients, because it doesn´t affect hemodynamics.
	list.mistral.net /pipermail/trauma-list/2005-June/026820.html (204 words)

	Should We Use Etomidate as an Induction Agent for Endotracheal Intubation in Patients With Septic Shock?: A Critical ...
		Should We Use Etomidate as an Induction Agent for Endotracheal Intubation in Patients With Septic Shock?: A Critical Appraisal -- Jackson 127 (3): 1031 -- Chest
		Etomidate is commonly used for the facilitation of endotracheal
		an appraisal of the status of etomidate as an induction agent
	www.chestjournal.org /cgi/content/abstract/127/3/1031 (302 words)

	LifeFlight (Site not responding. Last check: 2007-11-03)
		To outline the use of Etomidate during a prolonged extrication of a patient that is either resisting rescue efforts or in the flight nurses opinion, some muscle relaxation could facilitate the process.
		Etomidate is a non-opiate hypnotic, sedative-anesthetic agent that can be safely used in smaller doses without causing complete apnea and minimal if any hemodynamic effects.
		Although the smaller dose of Etomidate should not cause apnea, hypoventilation may occur and intubation may be necessary.
	www.mc.vanderbilt.edu /lifeflight/web/protocol/5m.htm (294 words)

	Seizure Upon Induction With Etomidate
		Etomidate, a carboxylated imidazole, is a drug used for induction of general anesthesia.
		During IV induction of anesthesia with Etomidate 10mg and Fentanyl 150mcg, patient experienced a generalized tonic-clonic seizure.
		Based on our observations and the previous reports, it is probably prudent to avoid etomidate in patients with a history of seizure activity as an induction agent, unless specifically indicated due to cardiovascular instability.
	www.ispub.com /ostia/index.php?xmlFilePath=journals/ija/vol5n4/seizure.xml (781 words)

	The use of etomidate in the management of severe head injury. (Site not responding. Last check: 2007-11-03)
		Continuous infusion of etomidate (5-25 micrograms/kg/min) proved to be a practical and safe means of sedating these patients and appeared to control moderately elevated ICP.
		The effects of continuous and supplementary bolus dose administration of etomidate have been investigated in ten artificially ventilated patients in traumatic coma.
		However, when the bolus of etomidate was not given, occasional dramatic and dangerous rises in ICP were seen, in spite of the infusion, during which CPP fell to critical levels.
	www.pdg.cnb.uam.es /UniPub/iHOP/gp/4356379.html (295 words)

	Firehouse Forums - Firefighting Discussion - Etomidate
		Etomidate 0.3 mg/kg IV over 30 to 60 seconds (max total dose of 20mg) or Versed 5.0 mg IV (additional versed or valium if intubation is successful) Also they have Flumazenil given @ 0.2 mg for valium/versed reversal.
		Etomidate is not a paralytic and must be used with one (such as Sux and/or Vec).
		Etomidate is a better induction agent than Versed as it works much faster and is more accurate (I.E. titration of versed).
	cms.firehouse.com /forums2/showthread.php?threadid=32275 (1873 words)

	The beta3 subunit of GABA(A) and etomidate-induced general anaesthesia (Site not responding. Last check: 2007-11-03)
		It was recently shown that the beta2 subunit contributes to the sedative properties of etomidate, whereas the beta3 subunit is responsible for its anaesthetic properties.
		However, these studies evaluated anaesthetic effects in point mutation mice in which the effect of etomidate was decreased, but not abolished, at the beta2 subunit.
		Etomidate was equally anaesthetic in wildtype and knockout mice, thus further confirming that efficacy at the beta3 subunit only is sufficient to induce general anaesthesia.
	www.general-anaesthesia.com /etomidate-gabaabeta3.html (138 words)

	Firehouse Forums - Firefighting Discussion - Etomidate
		Etomidate and Succinocholone were mentioned several times as being the same class of drug and used for a similar ariway management protocol.
		etomidate can cause a very painful myoclonis once the patient awakens, but valiun is a muscle relaxant and counteracts the myoclonus...plus it sedates like all other benzodiazipines.
		Etomidate has minimal hemodynamic effects and may be the drug of choice in a hypotensive or trauma patient.17 It causes less cardiovascular depression than either the barbiturates or propofol.
	cms.firehouse.com /forums2/showthread.php?s=af3f8c19eb7326a12f41fb7c5aa0a5a7&threadid=32275&pagenumber=2 (1619 words)

	Effects of thiopental, fentanyl, and etomidate on upper extremity somatosensory evoked potentials in humans.
		Effects of thiopental, fentanyl, and etomidate on upper extremity somatosensory evoked potentials in humans.
		Fentanyl increased N20 and P23 latency and decreased the amplitude of P15-N20.
		Etomidate increased latency of N20 and P23 without alteration of latencies of N10 or N14 and increased the amplitude of P15-N20 and N20-P23, while the amplitude of N10 was unchanged and the amplitude of N14 was decreased.
	www.pdg.cnb.uam.es /UniPub/iHOP/gp/5425748.html (243 words)

	Etomidate, Medetomidine, Diazepam - WSAVA 2002
		The aim of this work was to study alterations induced by the anaesthesia with etomidate on the cardiorespiratory and biochemical parameters in diazepam or medetomidine premedicated dogs.
		Procedure: 6 dogs were premedicated with diazepam (0.5 mg/kg) and anaesthesia was induced with etomidate (1.5 ± 0.6 mg/kg, i.v.) followed by i.v continuous etomidate perfusion (165 ± 20 µg/kg/min), during 60 minutes.
		Etomidate induction and maintenance doses were greater in diazepam group.
	www.vin.com /proceedings/Proceedings.plx?CID=WSAVA2002&PID=2868 (372 words)

	Etomidate for Procedural Sedation in the Emergency Department -- Falk and Zed 38 (7): 1272 -- The Annals of ...
		The use of etomidate for procedural sedation in the emergency department (abstract).Acad Emerg Med 2001;8:423.
		Administration of etomidate as a single agent for conscious sedation in the emergency department (abstract).
		Etomidate and midazolam for reduction of anterior shoulder dislocation: a randomized, controlled trial.
	www.theannals.com /cgi/content/full/38/7/1272 (3391 words)

	NEJM -- Inhibition of adrenal steroidogenesis by the anesthetic etomidate
		NEJM -- Inhibition of adrenal steroidogenesis by the anesthetic etomidate
		Inhibition of adrenal steroidogenesis by the anesthetic etomidate
		Four surgical patients receiving etomidate during their operations were all found to have adrenal suppression four hours after the operation; mean (+/- S.D.) increases in cortisol and aldosterone after ACTH stimulation were only 1.8 +/- 0.5 micrograms per deciliter and 0.5 +/- 1.1 ng per deciliter, respectively.
	content.nejm.org /cgi/content/abstract/310/22/1415 (492 words)

	Use of a Parenteral Propylene Glycol-Containing Etomidate Preparation for the Long-Term Management of Ectopic Cushing's ...
		Forty milligrams of propylene-glycol preparation of etomidate was infused over 3 h once per day beginning at 1800 h each day.
		Because etomidate is a lipophilic compound, storage of the agent
		Van Hamme MJ, Ghoneim MM, Ambre JJ 1978 Pharmacokinetics of etomidate, a new intravenous anesthetic.
	jcem.endojournals.org /cgi/content/full/86/9/4104 (3099 words)

	Etomidate Information and Resources Online at The Drug Database - Find Useful Articles and Websites on Etomidate Right ... (Site not responding. Last check: 2007-11-03)
		Influence of Hypovolemia on the Pharmacokinetics and the Electroencephalographic Effect of Etomidate in the Rat1.
		GABA) type A receptor on the multiple actions of the general anesthetics alphaxalone and etomidate were investigated...
		We have been aware of concern about using etomidate because of its association with adrenocortical...
	www.thedrugdatabase.com /directory/E/Etomidate (385 words)

	Midazolam is more likely to cause hypotension than etomidate in emergency department rapid sequence intubation -- Choi ...
		Midazolam is more likely to cause hypotension than etomidate in emergency department rapid sequence intubation -- Choi et al.
		and etomidate as induction agent in emergency department rapid
		and in phase two, etomidate 0.2–0.3 mg/kg was used.
	emj.bmjjournals.com /cgi/content/abstract/21/6/700 (220 words)

	Digitale Hochschulschriften der LMU - Intraoperative Wachheit, postoperative Erinnerung und Erholung ...
		Digitale Hochschulschriften der LMU - Intraoperative Wachheit, postoperative Erinnerung und Erholung nachgynäkologischen, tageschirurgischen Kurzeingriffen unter Narkose mit Propofol, Etomidate, Ketamin, Methohexital und Midazolam
		Die Etomidate- und Midazolam-Patientinnen lagen hinsichtlich ihrer postoperativen Erholung dazwischen.
		Unter Etomidate kamen intraoperative Wachepisoden nur selten vor.
	edoc.ub.uni-muenchen.de /archive/00000362 (1534 words)

	Etomidate for Pediatric Sedation Prior to Fracture Reduction -- Dickinson et al. 8 (1): 74 -- Academic Emergency ...
		Etomidate for Pediatric Sedation Prior to Fracture Reduction -- Dickinson et al.
		Etomidate for Pediatric Sedation Prior to Fracture Reduction
		Thirteen patients required a second bolus of etomidate or midazolam.
	www.aemj.org /cgi/content/abstract/8/1/74 (421 words)

	IngentaConnect Comparison of the effects of remifentanil or fentanyl on anaesthe... (Site not responding. Last check: 2007-11-03)
		Five minutes later, propofol, thiopental or etomidate were titrated to a state of unresponsiveness.
		The times to respiratory arrest or for the syringe to fall were significantly shorter with remifentanil than with fentanyl for propofol and for thiopental, but not for etomidate.
		However, within the remifentanil groups, mean arterial pressure significantly decreased during induction:-26% with propofol,-18% with thiopental and-14% with etomidate (all P < 0.01).
	api.ingentaconnect.com /content/gmed/eja/2002/00000019/00000005/art00006 (357 words)

	Etomidate for Rapid-sequence Intubation in Young Children: Hemodynamic Effects and Adverse Events -- Guldner et al. 10 ...
		Etomidate for Rapid-sequence Intubation in Young Children: Hemodynamic Effects and Adverse Events -- Guldner et al.
		Etomidate for Rapid-sequence Intubation in Young Children: Hemodynamic Effects and Adverse Events
		etomidate for RSI between July 1996 and April 2001.
	www.aemj.org /cgi/content/abstract/10/2/134 (415 words)

	Etomidate
		ETOMIDATE (Amidate®) induces sleep and relaxes you before a procedure.
		Do not to attempt driving or operating machinery for at least 24 hours after receiving etomidate.
		You should have a caregiver present to drive you home after outpatient procedures when you have received etomidate.
	www.pottstownfoundation.staywellknowledgebase.com /26,238 (267 words)

	Propofol - not thiopental or etomidate - with remifentanil provides adequate intubating conditions in the absence of ...
		Propofol - not thiopental or etomidate - with remifentanil provides adequate intubating conditions in the absence of neuromuscular blockade: [Le propofol, mais non le thiopental ou l'etomidate, combine au remifentanil, permet des conditions d'intubation satisfaisantes en l'absence de blocage neuromusculaire] -- Erhan et al.
		Biphasic EEG changes in relation to loss of consciousness during induction with thiopental, propofol, etomidate, midazolam or sevoflurane.
		Comparison of the effects of etomidate, propofol, and thiopental on respiratory resistance after tracheal intubation.
	www.cja-jca.org /cgi/content/full/50/2/108 (3106 words)

	IngentaConnect Effects of etomidate on free intracellular amino acid concentrati... (Site not responding. Last check: 2007-11-03)
		Thus, in the current study, we evaluated the effects of etomidate on free intracellular amino acid metabolism in PMN.
		Etomidate influenced important free amino acid profiles in PMN in a dose-dependent manner, indicating complex changes of cellular amino acid turnover.
		For the first time, the effects of etomidate on free intracellular amino acid metabolism in PMN have been investigated.
	www.ingentaconnect.com /content/mksg/aas/2000/00000044/00000004/art00012 (320 words)

	The effect of etomidate on adrenocortical function in dogs before and during hemorrhagic shock -- Fraser et al. 115 ...
		The effect of etomidate on adrenocortical function in dogs before and during hemorrhagic shock -- Fraser et al.
		The effect of etomidate on adrenocortical function in dogs before and during hemorrhagic shock
		(etomidate), on corticosteroidogenesis were studied in greyhound dogs
	endo.endojournals.org /cgi/content/abstract/115/6/2266 (240 words)

	Effects of metyrapone and etomidate on adrenal function and growth rate in female rats -- Sillence and Rodway 113 (3): ...
		Effects of metyrapone and etomidate on adrenal function and growth rate in female rats
		Two inhibitors of adrenal steroidogenesis were examined to determine whether the growth rate of female rats could be improved by lowering circulating plasma corticosterone concentrations.
		The first inhibitor, etomidate, is a potent narcotic agent and was found to have no effect on plasma corticosterone and deoxycorticosterone (DOC) concentrations at sub-narcotic doses.
	joe.endocrinology-journals.org /cgi/content/abstract/113/3/473 (352 words)

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